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HomeMy WebLinkAboutARNESS INC - INSURANCE CERTIFICATEACOR" CERTIFICATE OF LIABILITY INSURANCE DATE6/25/2019 Y) 06125/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Brianne Danielson, CISR NAME: Flood and Peterson A/CC, No Ext : (970) 266-7118 A C No): (970) 506-6846 E-MAIL s: BDanielson@floodpeterson.com ADDRE Corporate Mailing Address: tNSURERIS) AFFORDING COVERAGE NAIC 19 PO. BOX 578 INSURER A : Employers Mutual Casualty Company 21415 Greeley CO 80632 INSURED INSURER B : Plnnacol Assurance 41190 INSURER C : Arness, Inc. INSURER D : dba Silver Grill INSURER E : 218 Walnut Street INSURER F : Fort Collins CO 80524 rnvcaer_I=c rI=RTIFICATF NI IMRFR CL1962529949 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDD/YY P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE500,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 A 6DO-17-70-20 04/01/2019 04/01/2020 PERSONAL SADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,OOQ000 POLICY ❑PRO FLOC JECT Liquor Liability -Agg. $ 2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO BODILY INJURY (Per accident) $ A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY P 6EO-17-70-20 04/01/2019 04/01/2020 PROPERTY DAMAGE Per accident $ I Medical Payments $ 5,000 I X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESSLIIAB CLAIMS -MADE 6JO-17-70-20 04/01/2019 04/01/2020 AGGREGATE $ 1,000,000 DED I X1 RETENTION $ 0 $ rA B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 4058092 07/01/2019 07/01/2020 X PER OTH- /� STATUTE EERR E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE -POLICY LIMIT 500,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as Additional Insured as required by written contract with respects to liability arising out of a portable sign at the premise. r"c OTICIf'ATC unI nFA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522-05804llat cpie(rprU. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD